A patient is being admitted to the floor following a motor vehicle accident. because of the stressful nature of the event, the nurse anticipates the patient will continue to have a sympathetic reaction during the post operative period. When monitoring the patient's serum electrolytes, what will the nurse closely monitor?
Increased calcium
Deceased sodium
Decreased potassium
Increased chloride
The Correct Answer is C
A) Increased calcium: Sympathetic activation typically does not cause a direct increase in calcium levels. Calcium levels are more influenced by factors like parathyroid hormone (PTH) and vitamin D, or conditions such as bone disease or renal issues. Although some stress responses can lead to changes in calcium metabolism, an increase in calcium is not a typical response to sympathetic activation.
B) Decreased sodium: While sodium imbalances can occur in various conditions, the sympathetic nervous system does not directly cause a decrease in sodium. The body's handling of sodium is more influenced by factors like kidney function and the renin-angiotensin-aldosterone system. Stress-related changes in sodium levels are less likely to cause a significant decrease in sodium, making this an unlikely focus in monitoring.
C) Decreased potassium: During stress, the body releases catecholamines (like epinephrine) as part of the sympathetic nervous response, which stimulates the movement of potassium into cells. This can result in a transient decrease in serum potassium levels (hypokalemia). Monitoring for decreased potassium is important, as low potassium can lead to cardiac arrhythmias and muscle weakness, which are particularly concerning after surgery or trauma.
D) Increased chloride: Chloride is typically maintained in balance with sodium, and while it may shift in certain conditions, sympathetic activation does not directly lead to increased chloride levels. Most chloride imbalances are secondary to changes in sodium, acid-base disturbances, or kidney function. Therefore, an increase in chloride is less likely in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Risk for dehydration related to diarrhea:
Diarrhea is not a common issue directly associated with Parkinson’s disease or its typical treatments, such as dopaminergic medications. While some medications or conditions can cause gastrointestinal disturbances, dehydration due to diarrhea is not a primary concern in Parkinson’s disease.
B) Diarrhea related to dopaminergic effects:
Dopaminergic medications, such as levodopa, may cause gastrointestinal side effects, but diarrhea is not a primary or common side effect. Typically, dopaminergic effects can lead to constipation, not diarrhea.
C) Risk for injury related to CVS effects and incidence of orthostatic hypotension:
Parkinson's disease can cause autonomic dysfunction, which often leads to orthostatic hypotension increasing the risk of falls and injury. This is a valid and appropriate nursing diagnosis because patients with Parkinson’s disease often experience balance issues and dizziness due to this condition, making them more vulnerable to falls and injury.
D) Constipation related to dopaminergic effects:
While constipation is a common side effect of dopaminergic medications used to treat Parkinson's disease, the more appropriate diagnosis for a patient who has Parkinson’s disease would be one that addresses the immediate risks or complications related to mobility or autonomic dysfunction.
Correct Answer is B
Explanation
A) Tell the spouse that medication therapy can be curative if drugs are begun in time: Medication for Parkinson's disease (PD), such as levodopa, can help manage symptoms, but it is not curative. PD is a progressive neurodegenerative disease, and while medications can improve quality of life by alleviating symptoms, they do not stop the disease’s progression. Therefore, suggesting that medication therapy can be curative would be misleading.
B) Recommend exercise, nutritional counseling, and group support to help manage the disease: This is the most accurate and appropriate response. While medications are an important part of managing Parkinson's disease, non-pharmacological approaches, such as exercise, nutritional counseling, and support groups, play a critical role in improving overall function, mobility, and quality of life. Exercise, in particular, can help maintain mobility and reduce rigidity, while a balanced diet can assist in managing issues like constipation or swallowing difficulties. Group support can provide emotional support and help the patient and family navigate the challenges of living with PD.
C) Tell the spouse that the disease will not progress if mild symptoms are treated early: Parkinson's disease is a chronic, progressive condition, and while early treatment can help manage symptoms, it does not prevent the disease from progressing. Suggesting that the disease will not progress if symptoms are treated early would be unrealistic and could create false hope.
D) Counsel the spouse that parkinsonism is a normal part of the aging process in some people: While Parkinson's disease symptoms may appear in older adults, it is not a normal part of aging. Parkinson’s disease is a specific neurodegenerative condition, and its symptoms, such as tremor, bradykinesia, and rigidity, go beyond normal age-related changes. Misleading the spouse by categorizing it as "normal aging" would undermine the importance of proper diagnosis, treatment, and care.
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